The lump on your wrist may look worrisome, but if your physician has diagnosed it as a ganglion cyst, there is no cause for alarm. Although they may grow larger, particularly after vigorous activity, these fluid-filled growths are not cancerous and will not spread. Frequently, ganglion cysts cause continuous aching pain that is worsened by activity. Ganglion cysts may result from a sudden injury or blow to the wrist or from repetitive activities, such as playing tennis, that stress the joint. When the wrist joint is strained or not moving properly, the synovial tissue cushioning the bones becomes irritated and squeezes out from between the bones forming a pouch under the skin that fills up with synovial fluid.
Ganglion cysts usually require no treatment, although wearing a wrist brace during activity may ease pain. Some cysts simply disappear over time; others come and go. However, many patients want the bump removed for aesthetic reasons. Aspiration is the treatment of choice to remove a cyst. After numbing the wrist, the physician then uses a needle and syringe to draw out the fluid. While this procedure is usually successful, the cyst often returns, and several aspirations may be needed to permanently remove it. Surgery is recommended when the cyst recurs despite repeated aspirations, causes severe pain or interferes with normal activities. The surgery is usually performed on an outpatient basis, after which the wrist is bandaged and placed in a splint. An exercise program begun soon after treatment can ease stiffness and increase circulation, strength and range of motion (ROM). In passive ROM exercises, the therapist gently rotates the wrist in full circles. Active ROM exercises, performed by you, stretch the wrist and increase flexibility. Other wrist-strengthening exercises performed either with a therapist or by you include squeezing Silly Putty to contract the wrist and hand muscles, and flexing and extending the wrist while holding light weights. If your physician recommends physical therapy after treating your ganglion cyst, we will create an exercise program that will restore circulation, increase muscle strength and attain full joint mobilization—all of which will accelerate your recovery and may help prevent a ganglion cyst from forming again as well.
